Patil A A, Andrews R, Torkelson R
Section of Neurosurgery, University of Nebraska Medical Center, Omaha, USA.
Stereotact Funct Neurosurg. 1997;69(1-4 Pt 2):210-5. doi: 10.1159/000099876.
Dominant seizure foci (DSF) are seizure foci that do not respond to multiple subpial transections (MST). DSF were isolated in 15/31 patients who underwent MST in the past 6 years. These patients had MST over both hemispheres (6 patients) or over multiple lobes of one hemisphere (9 patients). DSF measured 0.5-1 cm in diameter and numbered 1-4 (in each patient). Their excision resulted in dramatic improvement in EEG over wide areas of the cortex. The longest postoperative follow-up is 67 months, with a median of 21 months. Nine of 15 patients are free of seizures, 3/15 have rare seizures, 2/15 have > 90% reduction in seizure frequency, and 1/15 has > 70% reduction in seizure frequency with improvement in motor and speech functions. In summary, DSF are resistant to MST and influence the electrical activity of the surrounding cortex. MST combined with excision of DSF resulted in good seizure control in this series, which included patients with multilobar and bihemispheric seizure foci.
优势癫痫病灶（DSF）是对多次软膜下横切术（MST）无反应的癫痫病灶。在过去6年接受MST的31例患者中，有15例分离出了DSF。这些患者在双侧半球（6例患者）或一侧半球的多个脑叶（9例患者）进行了MST。DSF直径为0.5 - 1厘米，数量为1 - 4个（每位患者）。切除DSF后，皮层广泛区域的脑电图有显著改善。术后最长随访时间为67个月，中位随访时间为21个月。15例患者中有9例无癫痫发作，3/15有罕见癫痫发作，2/15癫痫发作频率降低> 90%，1/15癫痫发作频率降低> 70%且运动和语言功能改善。总之，DSF对MST有抗性，并影响周围皮层的电活动。在本系列研究中，MST联合DSF切除可有效控制癫痫发作，该系列研究纳入了多脑叶和双侧半球癫痫病灶的患者。
